The present invention relates to a suturing device used with an endoscope for suturing a tissue in a body cavity or stanching blood.
Endoscopic suturing devices are known. One such device is described, for example, in U.S. Pat. No. 5,037,433 to Peter J. Wilk.
Recently, developments in the endoscopic treatment procedure have been remarkable: medical treatment may be received without major surgery in some cases such as an abdominal section. Since, suturing of tissue after perforation in a body cavity or stanching of blood are very important endoscopic techniques, efforts have been made to develop such techniques.
For example, U.S. Pat. No. 5,037,433 discloses a method in which an elongate flexible outer tubular endoscope member comprises multiple flexible lumens, a flexible endoscope being arranged in one of said lumens, an inner tubular member being arranged in another one of the lumens, and a forceps device with forceps in an elongate flexible body portion being arranged in a further one of the lumens. A curved needle can be elastically transformed and inserted into the inner tube in a stretched-straight state. Also the curved needle has a suture member on the proximal end side. For suturing, the curved needle is pushed out from the inner tube by pushing the rod members, which are arranged to push out the curved needle, arranged on the distal end of the inner tube. At the same time, the restoring force is utilized to suture a wound in a body cavity.
Since the device disclosed in U.S. Pat. No. 5,037,433 uses an elastic curved needle inserted in a narrow inner tube in a stretched straight state. However, the curved needle cannot stick deeply into the tissue because the sticking force is reduced by resistance between the inner tube and the curved needle caused by the restoring power of elasticity of the curved needle when the curved needle is pushed out from the inner tube by the rod member.
In addition, the flexible outer tubular endoscope member cannot be bent sufficiently because the rod member has a certain rigidity to push out the curved needle from the inner tube. Further, since the curved needle cannot be backed into the inner tube once the curved needle is stuck into the tissue, adjustment cannot be made when the curved needle slips off the target. Moreover, a greater diameter of the flexible outer tubular endoscope member due to its multi-lumen structure including an endoscope, suturing member, and forceps device may increase the pain of the patient. Furthermore, the separation structure of the endoscope and suturing device may decrease the manipulability.
By solving the above-mentioned problems, the present invention is intended to provide an endoscopic suturing device in which the sticking force can be efficiently transmitted to the curved needle at any angle of the endoscope, the sticking location can be corrected several times, the outer diameter of the entire body can be smaller, the manipulability of endoscope and suturing device can be improved, and the target location can be easily approached with the operating angle of the endoscope.
This is done with an endoscopic suturing device comprising an endoscope, a curved needle detachably arranged at the distal end portion of or integrally embedded in the endoscope for suturing a tissue of the living body, a suture for suturing the tissue with the curved needle, and a driving means arranged on the endoscope and operating the curved needle.
The suturing device, detachably or integrally attached to the end of the endoscope, has a curved needle detachably or integrally attached to the driving member. The curved needle has a perforation through which a suture can pass: the suture passing through a channel of the endoscope from the proximal end to the distal end passes through the perforation.
The endoscope, at the distal end of which the suturing device with the curved needle contained in the protective member is mounted, is introduced to a suturing target in a human being or animal body cavity. The curved needle is moved to the target region by manipulating the control section arranged on the proximal side of the endoscope for controlling the curved needle, and the suturing device is pressed on the region to be sutured, for example, by angling the endoscope. While the suturing device is being pressed on the region, the curved needle is stuck into the tissue by manipulating its control section.
After sticking into the tissue, the tip of the needle and the suture are confirmed on the surface of the tissue in the field of view of the endoscope, an end of the suture is grasped with the grasping member and brought to the proximal side with the grasping member. The curved needle is returned with the suture grasped on the proximal side of the endoscope, and the curved needle is stuck into another region near the already stuck location. Then, another end of the suture is grasped with the grasping member and brought to the proximal side with the grasping member.
A knot is made with the two obtained ends, and pushed forward to the target region through a channel of the endoscope by the knot pressure. By repeating the above-mentioned process several times, the tissue can be sutured.